6: Ovarian cancer

Question 1

Which fluid-filled epithelial sacs can form in the ovaries?

Answer 1

Ovarian cysts

Question 2

Where specifically do ovarian cysts most commonly arise?

Answer 2

Follicles

Question 3

What is the pathogenesis of follicular ovarian cysts?

Answer 3

Follicle fails to rupture, forming a fluid-filled cyst instead

Usually self-resolving

Question 4

What is endometriosis?

Answer 4

Endometrial tissue outwith the body of the uterus

Question 5

Where can endometriosis arise?

Answer 5

Ovaries

Peritoneal cavity - rectouterine pouch, SURFACE of uterus, bowel or bladder

Cervix, vagina

Question 6

What are chocolate cysts?

Answer 6

Endometriosis found on the surface of the ovaries

NOT actual cysts

Question 7

What is endometriosis called when it arises on the surface of the ovary?

Answer 7

Chocolate cyst

Question 8

What are the main symptoms of endometriosis?

Answer 8

Pelvic pain

Dyspareunia

Infertility

Question 9

When is the pelvic pain of endometriosis particularly bad?

Answer 9

During menstruation (because the abnormal endometrium sheds as well)

Question 10

Some endometriomas can go on to develop into what?

Answer 10

Endometroid carcinomas

epithelial tumours

Question 11

The vast majority of ovarian tumours are derived from which type of cell?

Answer 11

Epithelial cells

therefore they are carcinomas

Question 12

Which type of ovarian carcinoma is associated with endometriosis?

Answer 12

Endometrioid carcinoma

Question 13

Which type of ovarian carcinoma is the most common?

Answer 13

Serous carcinoma

Question 14

Which syndrome, causing colorectal cancer, is linked to endometrioid carcinomas of the ovary?

Answer 14

HNPCC (hereditary non-polyposis colorectal carcinoma)

otherwise known as Lynch syndrome

Question 15

Ovarian tumours can grow to become very ___.

Answer 15

large

Question 16

Apart from epithelial cells, in which other cells can ovarian cancer develop?

Answer 16

Germ cells

Egg cells in women, sperm cells in men

Question 17

Which germ cell tumour accounts for 15-20% of ovarian tumours?

Answer 17

Teratoma

Question 18

What are mature ovarian teratomas also known as?

Why?

Answer 18

Dermoid cysts

Derived from all three germ layers - so contain hair, skin, resp. epithelium - weird mishmash of tissues

Question 19

Are teratomas (dermoid cysts) benign or malignant?

Answer 19

Benign

Question 20

Which developmental structures may ovarian tumours be derived from?

Answer 20

Sex cords

Question 21

Because oestrogen is produced by the ovaries, which primary cancer can spread there?

Answer 21

Breast cancer

Question 22

The ovaries are closely related to the abdominal organs because they are all found within the peritoneal cavity.

This allows the spread of which primary cancers to the ovaries?

Answer 22

Stomach

Pancreas

Colon

Question 23

If tumours are found in both ovaries, what should you suspect?

Answer 23

Secondary invasion from other organs

Question 24

Endometriosis can cause which abnormal pregnancy if affects the ovaries or fallopian tubes?

Answer 24

Ectopic pregnancy

Question 25

Which structures, closely related to the ovaries, can also develop epithelial tumours?

Answer 25

Fallopian tubes

Question 26

What is inflammation of the Fallopian tubes called?

Answer 26

Salpingitis

Question 27

What is a consequence of untreated ectopic pregnancy?

Answer 27

Massive haemorrhage

Question 28

What are signs of an ectopic pregnancy?

Answer 28

Acute abdomen

Sudden hypotension

in a woman with amenorrhoea

Question 29

The signs of ectopic pregnancy are an acute abdomen and sudden hypotension in a woman with ___.

Answer 29

amenorrhoea